Chalazion

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Meibomian gland lipogranuloma

Overview

A chalazion is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. Chalazions differ from styes (hordeolums) in that they are usually painless apart from the tenderness caused when they swell up. A chalazion may eventually disappear on its own after a few months, though more often than not, some treatment is necessary.

Natural History, Complications and Prognosis

A large chalazion can cause astigmatism due to pressure on the cornea. This will resolve with resolution of the chalazion.

Complications including, but not limited to hypopigmentation may occur with corticosteroid injection.

The presence of a recurring chalazion in the same area sometimes leads to a consideration of sebaceous cell carcinoma.

The minor operation is quite painless, the eyelid is injected with a local anesthetic a clamp is put on the eyelid, then the eyelid is turned over and the chalazion is scraped out.

Diagnosis

History and Symptoms

  • Swelling on the eyelid
  • Eyelid tenderness
  • Sensitivity to light
  • Increased tearing

Physical Examination

Eyes

Chalazion (away from lid margin).jpg[1]


Treatment

Medical Therapy

The primary treatment is application of warm compresses for 10 to 20 minutes at least 4 times a day. This may soften the hardened oils blocking the duct and promote drainage and healing.

Topical antibiotic eye drops or ointment (eg chloramphenicol or fusidic acid) are sometimes used for the initial acute infection, but are otherwise of little value in treating a chalazion. Chalazia will often disappear without further treatment within a few months and virtually all will resorb within two years.[2]

Surgery

If they continue to enlarge or fail to settle within a few months, then smaller lesions may be injected with a corticosteroid or larger ones may be surgically removed using local anesthesia.[3][4] This is usually done from underneath the eyelid to avoid a scar on the skin. Rarely chalazia may reoccur and these will be biopsied to help rule out tumors.

Primary Prevention

Proper cleansing of the eyelid may prevent recurrences in people prone to chalazia. Cleaning the eyelash area with diluted baby shampoo will help reduce clogging of the ducts.[5]

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References

  1. http://picasaweb.google.com/mcmumbi/USMLEIIImages
  2. Chalazion Template:GPnotebook
  3. Khurana A, Ahluwalia B, Rajan C (1988). "Chalazion therapy. Intralesional steroids versus incision and curettage". Acta Ophthalmol (Copenh). 66 (3): 352–4. PMID 10994460.
  4. Jackson T, Beun L (2000). "A prospective study of cost, patient satisfaction, and outcome of treatment of chalazion by medical and nursing staff". Br J Ophthalmol. 84 (7): 782–5. PMID 10873994. — in which of those cases attending a District General Hospital, approximately one third of selected chalazia resolved within 3 months with conservative treatment, and surgical treatment was successful for 72%.
  5. (UK) Moorfields Eye Hospital. "Blepharitis — Lid Hygiene Advice For Patients" (DOC). — Patient information leaflet

ar:البردة de:Chalazion it:Calazio nl:Chalazion


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